In severe kidney failure, the harmful substances and excess water that is formed during the breakdown of the food in our body and which are normally excreted in urine cannot be eliminated and accumulate in our body. Hemodialysis is a form of treatment that allows these substances to be eliminated from our body. The patient’s blood is passed through the tubes made of a thin membrane (dialyzer) and removed from the body as the membrane is mixed with a fluid passing through it (dialysis solution-dialysate). For this, some of your blood is taken from a vein or catheter in your arm through a needle or a tube (catheter). The filtered and cleaned blood is returned to your vein/catheter with the help of a second needle/catheter. This form of treatment is carried out continuously, at least 4 hours or more in each session. This process is carried out in our dialysis center by the nurses and physicians specializing in this field. Thetreatment is usually applied 3 times a week depending on your health. How many times a week and how many hours will be decided each month, based on your blood tests, physical examination and general condition.
What you should know before the hemodialysis treatment:
In order to perform hemodialysis treatment, it is necessary to establish a suitable vascular access specific to this procedure. Vascular access is one of the most important elements of hemodialysis treatment.
Vascular access options used in hemodialysis,
1.Fistula (natural vascular access)
2.Graft (artificial vascular access)
1)Fistula: It is the first natural vein route to be preferred for hemodialysis patients. It is performed by a cardiovascular surgeon with a minor operation. It is a merging procedure applied between the person’s artery and vein with small surgical intervention carried out in hospital conditions. This procedure is preferred to be applied to your forearm or upper arm, which you do not actively use. After the procedure, a waiting period of 4 to 6 weeks is required for your fistula to mature and to allow comfortableneedle insertions. Do not forget that this waiting period is important for the maturation of the vein. Do not measure blood pressure in any way or get your blood drawn from the arm with the fistula. Check whether your fistula is working by making a daily control. For your fistula to mature,it is very important that you do the exercises and recommendations, daily check the functioning of the fistula and report the changes to your dialysis center without delay. Do not forget to ask the cardiovascular surgeon opening your fistula for your vascular map showing the needle insertion regions and share this information with your dialysis center. It should also be remembered that this process can be repeated if your vein is not sufficiently developed or blocked.
2)Graft: It is an artificial vascular access route for hemodialysis patients. It is the procedure of subcutaneously inserting an artificial vein under your skin between your arteries and veins with a small surgical intervention by cardiovascular surgeons in hospital conditions. Likewise, it is also very important that you do not measure blood pressure or get your blood drawnfrom your arm/leg where graftwas opened, daily check whether your graft is working and report the changes to your dialysis center without delay. Also, do not forget to ask the cardiovascular surgeon opening your fistula for your vascular map showing the needle insertion regions and share this information with your dialysis center.
3)Where the Catheter can be inserted: It can be applied to the right or left neck vein, the right or left groin vein and the vein under the right/left collarbone.
Do not forget that you will be kept under close observation by your hemodialysis nurse and physician in order to prevent adverse side effects that may occur during treatment,that the dialysis treatment will be specific for you, and your treatment will be specially planned and constantly reviewed.